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Wednesday, April 20, 2011

Hard Choices

Why I Might Need a Medicare Supplement Plan

I hated to admit it but after years of dodging the issue of some other kind of supplement to counteract the costs that Medicare parts A and B don't cover, I decided to look into it. For at least three years I stuck my head in the sand saying I couldn't afford a third premium.
In May of this year, the billing department at my doctor's office made me pay two years of unpaid visits totaling $96.36, which I paid in full. I called in October of 2007 looking for the first charge. The lady on the phone said Medicare would handle it and that I was fine. They called me into the billing department in 2008 and told me of the $49.30 I owed from 2007. After explaining to her that I never got the bill, she made me pay a $49 co-pay before proceeding to the triage area. I never received the bill from '07 or the new charges incurred from '08. I asked the new people in that office to find out why I wasn't getting my bill. All they would say was that Medicare had to refile in '08, and that we send out bills once a month. Something wasn't right because I never got a bill.
Now, for the reason I need a Medicare Supplement Plan, my doctor bill for May of 2009 was $139.82. That covered the May 12 visit and the follow up visit May 26 after the blood work. Medicare only covered $68 of this bill because on the bottom of the Medicare Summary notice, it said I have used $68 of the annual $135 deductible. The reason why I had a big charge was, the second visit ran 5 minutes over the traditional 10-minute limit. It cost me $8 per minute, which made my bill $40 higher. Medicare only paid $10 for the lab work and $20 for the first visit, there were probably a few other charges not marked on my bill but they are marked on the summary notice.
While a lot of people don't think a $140 doctor bill isn't all that bad, another bill like this in the same year would hurt someone on a fixed income. They seem to forget I paid a chunk in addition to this bill too of back charges. I want a supplement to cover what Medicare parts A and B don't, If I find a little coverage for Medicare Part D,
I won't complain. Because of all the procedures done on my lower extremities in 2005, I now know how it hurts to pay for meds out of my pocket. The blood thinner I took cost $91.40 for a 30-day supply. I split it into two payments of $45.70, putting it on a credit card. This happened two months before Medicare Part D Prescription Drug Coverage opened to the public.
Mom suggested I try to get Medicaid to pick up my expenses. In the state of Texas, under a program called QMB or Qualified Medicare Benificiary, one can do that, but they have income requirements. One can make up to but no more than $903. I make more than then that amount. Once they see my bank statement, it will show I can make my premiums. Full medical coverage wouldn't be possible. My friend at church, Ms. Charli Tulk who is on this program, discovered this when we discussed this issue two months ago on the phone.
I don't know how many online medical forms I filled out on Tuesday, August 25, 2009, but I was bombarded with calls starting at 11:25 a. m. with Medigap360. This man asked me the necessary questions to determine whether I was eligible for coverage. After 10 minutes of third degree, the agent informed me the only company in Texas that would insure me was AARP. Since he already knew my birth date, we both knew I was too young for that program. His advice was to sit tight, wait till I turned fifty, and sign up then. After what I went through in 2005 and a few months ago, that wasn't the smartest option. I had been rejected two times for supplement coverage before 2 p.m. because the agents that contacted me didn't do that. However, the agent from IMAC said he could place me in contact with agents that covered Medicare Supplement Plans in his company. By this time, I had decided to go with Blue Cross Blue Shield of Texas. Blue Medicare Rx covers me on Medicare Part D. Maybe they had Medicare Supplement Plans. As luck would have it, they did.
I filled out the form on line, but it wouldn't go through, so I copied the 1-800 number down and dialed it. That was a mistake, because it was the wrong department. I went through two more toll free numbers and a host of automated menus before getting to the right department, I begged the third operator to transfer me because my head throbbed so badly. She connected me to a lady named Sara. After answering Sara's inquiries on my health and whether I had Medicare A and B and what type of Social Security I received, she put me on hold, but not before taking my address and phone number. I also mentioned that her company covered my Medicare Part D Plan. After putting me on hold, she told me to expect a packet in the mail of Medicare Supplement Plans and premiums, with her card in it.
Right now, it doesn't hurt to look into the issue of Medicare Supplement Plans. I was warned that it wasn't cheap to do this, especially through Blue Cross Blue Shield of Texas. Hopefully, by the time I need the above, there will be an act of congress forcing medical companies to low their rates so that everyone will be able to afford coverage. I forgot to factor in my $135 Medicare A and B Deductible. Prices get lower when it gets used up. Hopefully, by the time I need the above, there will be an act of congress forcing medical companies to low their rates so that everyone will be able to afford coverage. While it doesn't look like that will happen this year, there is a way to make your voice heard. I would read the Myths vs Facts page at the end of this article first and watch the video. I saw the video on television this weekend. Go to Healthactionnow at the end of this article. Click on your state of residence. It will give you the list of House and Senate Representatives. Use the form letter on the right to place those names in the form before sending.
Yes, this decision was very hard to make, but I'd rather do it before another medical catastrophe hits me that I'm unprepared for than afterwards. Now is not the time to stick my head in the sand or talk myself out of getting coverage by saying I couldn't afford it.

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